Parents who think fruit juice is a healthy haven in a minefield of sugary kids' snacks should think again. According to a recent statement by the American Academy of Pediatrics (AAP), fruit juice contains no nutritional benefits for infants under 6 months old, and can be harmful to adolescents and teens if consumed in large quantities.

The new standards, published in the May issue of the AAP's journal Pediatrics, attributes numerous digestive and nutrition issues affecting children to the disproportionate role of fruit juice in their diets. While the AAP recognizes 100% fruit juice as a valuable source of folic acid, potassium and vitamins A and C, it says that over-consumption can lead to diarrhea, flatulence, abdominal distention, cavities and malnutrition. Some controversial studies even draw a correlation between excessive fruit juice intake and childhood obesity and short stature.

Too Much Juice?

According to the AAP, each American consumes an average of nine gallons of juice each year. While children under 12, the vast majority of juice consumers, make up only 18% of the population, they consume 28% of juice and juice drinks. Drinking more juice often means drinking less milk, AAP doctors say. They add that calcium is vital to bone development and milk is a primary source of calcium. This is supported by the Center for Disease Control's assessment that more than 50% of adolescent men and 80% of teenage girls don't meet dietary recommendations for calcium intake.

"I think people look at juice as containing lots of vitamins and minerals that are good for kids without seeing the fact that juices are really narrow and limited in terms of the nutrients provided when compared with something like milk," says Dr. Mel Heyman, a member of the AAP's committee on nutrition and the Chief of the Division of Pediatric Gastroenterology and Nutrition at the University of California San Francisco.

The new guidelines suggest that infants younger than six months consume only breast milk and are not introduced to any type of fruit juice. For children between the ages of one and six, 100% juice consumption should be limited to between four and six ounces, and eight to 12 ounces for children ages seven to 18. According to Food and Drug Administration guidelines, only 100% juice can be called "juice" on store shelves, and other juice drinks with smaller amounts are labeled as drinks or cocktails.

Filling the Gap

Children should not be fed juice from bottles or covered cups that encourage sucking and steady consumption, as these activities are proven to lead to tooth decay. They should also not be fed juice at bedtime. The AAP encourages parents to replace their children's juice intake with whole fruits, which contain water and fiber that juices lack. Juice, which consists mainly of sugars that can inhibit water absorption in the body, is not an effective method for re-hydration, the AAP cautions. When children do drink juice, parents should ensure that they consume 100% fruit juice, and not fruit drinks or other beverages with variable amounts of real juice.

"It's meant as a guideline, it's certainly not a law ... if you start getting into too much juice, then you start running into potential problems," Heyman says. "Our studies show that when you cut back on the juice a lot of these problems are resolved."

But the guidelines have also been met with cautious criticism by doctors who worry that the warnings will scare parents away from juices and leave a dietary gap likely filled by less nutritious foods.

"Our studies showed that as juice intake decreased over time the intake of carbonated soft drinks went up," says Jean Skinner, Ph.D., professor of Nutrition at the University of Tennessee and a registered dietician. Skinner has been monitoring juice intake and children's eating habits since 1992 in a study funded by Gerber foods. Skinner agrees with the cautions against tooth caries, but thinks the AAP guidelines fail to present the whole picture.

"If they don't drink juice, what are they going to drink instead?" She asks. "They [the AAP] didn't suggest alternatives, and certainly juice is a better choice than carbonated beverages, especially for children."

Dr. Heyman agrees. "If you're going to give a child a choice between juice and soda, I would say juice. If you're going to give them a more balanced diet, then I would say replace juice with water," he says, acknowledging that physical activity is also an important factor in considering juice intake. "If you have a 12 yr old who is doing a lot of sports and burning up a lot of calories, then taking more than 12 ounces of juice is not going to hurt them. But the guideline is a good starting point."

AAP Guidelines in Summary:

Juice should not be fed to infants younger than six months.

Young children should not be fed juice in bottles or cups that encourage constant consumption. They should not drink juice at bedtime.

Intake of 100% juice should be limited to four to six ounces for children 1 to 6 years; eight to 12 ounces a day (two servings) to children 7 to 18 years old.

Whole fruit and water consumption should be encouraged.

Pure juice should not be confused with juice drinks or cocktails containing less than 100% natural fruit juice.